Wyoming Voter Registration Form

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INSTRUCTIONS FOR COMPLETING & SUBMITTING
VOTER REGISTRATION APPLICATION FORM
YOU MAY USE THIS FORM TO: REGISTER TO VOTE IN WYOMING OR TO CHANGE YOUR REGISTRATION (NAME, ADDRESS OR PARTY)
 Register at the county clerk’s office: Print out the form & sign it in front of any registry agent.
OR

Register by mail: Voters who are not currently in Wyoming or who cannot go to the County Clerk's
office may register by mail. Follow the instructions below to mail in your voter registration application:
1. Print out the voter registration form and fill it out in front of a notary or person authorized to
administer oaths. Print clearly, using a black or blue ink pen (not felt tip).
2. Show identification to the notary or registry agent. See list of acceptable documents below:
Preferred
identification
Second option if you don’t have
valid Wyoming driver’s license
Valid Wyoming
driver’s license
Different state’s driver’s license;
ID issued by a local, state or
federal agency; U.S. passport;
school ID; military ID
Third option: 2 of any of the following
documents
Certificate of US citizenship or naturalization;
draft record; voter registration card from another
state or county; original or certified copy of birth
certificate bearing an official seal; certificate of
birth abroad issued by U.S. State Department; any
other form of ID issued by an official agency
3. Sign the voter registration oath on the form and have the notary or registered agent sign the form.
4. Make copies of the identification documents you showed to the notary.
5. Mail the voter registration form, along with the copies of your ID documents, to your County Clerk.
Note: Sending your form to any other office will delay your voter registration.
6. Mail your form as soon as possible. Voter registration closes two weeks prior to an election.
7. Follow up with your County Clerk about any questions you may have about your registration or requests for
absentee ballots. See http://soswy.state.wy.us/Elections/CountyClerks.aspx for contact details.
W Y O M ING CO UNT Y C LE RK S
Albany County Clerk
525 Grand Ave, Ste 202
Laramie, WY 82070
Hot Springs County Clerk
415 Arapahoe
Thermopolis, WY 82443-2783
Sheridan County Clerk
224 S Main St, Ste 17
Sheridan, WY 82801-4855
Big Horn County Clerk
County Courthouse, PO Box 31
Basin, WY 82410-0031
Johnson County Clerk
76 N Main St
Buffalo, WY 82834-1883
Sublette County Clerk
PO Box 250
Pinedale, WY 82941-0250
Campbell County Clerk
PO Box 3010
Gillette, WY 82717-3010
Laramie County Clerk
PO Box 608
Cheyenne, WY 82003-0608
Sweetwater County Clerk
80 W Flaming Gorge Way, Ste 155
Green River, WY 82935
Carbon County Clerk
PO Box 6
Rawlins, WY 82301-0006
Lincoln County Clerk
J925 Sage Ave, Ste 101
Kemmerer, WY 83101
Teton County Clerk
PO Box 1727
Jackson, WY 83001-1727
Natrona County Clerk
PO Box 863
Casper, WY 82601-0863
Uinta County Clerk
PO Box 810
Evanston, Wy 82930-0810
Crook County Clerk
PO Box 37
Sundance, WY 82729-0037
Niobrara County Clerk
PO Box 420
Lusk, WY 82225-0420
Washakie County Clerk
1001 Big Horn Ave
PO Box 260
Worland, WY 82401
Fremont County Clerk
450 N 2nd St, Rm 220
Lander, Wy 82520-0090
Park County Clerk
1002 Sheridan
Cody, WY 82414-3589
Weston County Clerk
1 W Main
Newcastle, WY 82701-2121
Goshen County Clerk
PO Box 160
Torrington, WY 82240-0160
Platte County Clerk
PO Drawer 728
Wheatland, WY 82201-0728
Converse County Clerk
107 N 5th St, Ste 114
Douglas, WY 82633-2448
Wyoming Voter Registration Application & Change Form
New Voter Application
VR # ___________________ County # ________
District _________ Precinct _________ Split __________
School __________ House __________ Senate_________
Municipality __________ Ward ____________
Change to Current Registration
Name Change
1. Name and Date of Birth
Legal
Last Name
Legal
First Name
Date
of Birth
County
Resident Since
Legal
Middle Name
Suffix
2. Wyoming Driver’s License You must provide this number if you hold a valid Wyoming Driver’s License
Valid Wyoming Driver’s License Number:
Mark here only if you do not have a valid Wyoming Driver’s License and go to step 2a.
2a. Social Security Number Last four digits are required if you do not have a valid Wyoming Driver’s License
Social Security Number
Mark here only if you do not have a valid Wyoming Driver’s License or a Social Security Number.
3. Personal Information * Denotes optional information
Gender*
Male
Wyoming Residence Address (No P.O. Box Numbers)
Female
City
Address Where You
Get Your Mail
Mailing
City
Phone*
Are you interested in being an Election Judge?*
Yes
No
E-mail*
Do you need assistance to vote? *
Yes
No
4. Political Party
Choose one of the following
Republican
5. Changes to Current Wyoming Voter Registration
Former Wyoming Residence
Street Address
City
Former
Last Name
Former
First Name
5a. Withdrawal of Voter Registration from Another State
Street Address
City
Democratic
Zip
State
Libertarian
WY County
Residence address in prior State
County
Constitution
Zip
Unaffiliated
State
Wyoming
Zip
Former
Middle Name
Suffix
State
Zip
6. Registration Oath and Acknowledgement Required on all applications.
I do solemnly swear (or affirm) that I am a citizen of the United States; that I am a bona fide resident of the state of Wyoming and this county; that if registered in
another county or state, I hereby request that my registration be withdrawn; that I will be at least eighteen (18) years of age on or before the next election; that I
am not currently adjudicated a mentally incompetent person; that I have not been convicted of a felony, or if I have been convicted of a felony, I have had my civil
or voting rights restored by a competent authority; and that the voter registration information contained herein is true and accurate to my best knowledge and
belief.
Sign your legal name
in full
Proof of Identification Shown
Type of Identification
Subscribed and affirmed or sworn to before me by
__________________________________________________________ (name of applicant) on ____________________________ (application date)
Title
Signature & Title of Registry Agent or
person authorized to administer oaths
3/2014
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